Provider Demographics
NPI:1508097510
Name:SACKETT, CHELSEA LYNN (MT)
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:LYNN
Last Name:SACKETT
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-5100
Mailing Address - Country:US
Mailing Address - Phone:724-925-9220
Mailing Address - Fax:724-925-3742
Practice Address - Street 1:403 S 3RD ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-5100
Practice Address - Country:US
Practice Address - Phone:724-925-9220
Practice Address - Fax:724-925-3742
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist